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3 - Reproduction > Infections of the Reproductive Tract > Flashcards

Infections of the Reproductive Tract Flashcards

1
Q

Describe the epidemiology of STI patients

A
  • Age - 15-24
  • Ethnicity
  • Socio-economic status - poorer people
  • Age at first sexual intercourse - younger
  • Number of partners
  • Sexual orientation - gay men more likely
  • Condom use
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2
Q

What are causes of vaginal discharge

A
  • Chlamydia
  • Gonorrhoea
  • Trichomonas vaginalis - yellow/green
  • Bacterial vaginosis - thin, milky white
  • Vulvovagina candidiasis - thick, white
  • Herpes
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3
Q

What are causes of genital ulceration

A
  • Herpes

- Syphilis

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4
Q

What are causes of urethral discharge

A
  • Gonorrhoea
  • Chlamydia
  • Trichomonas vaginalis
  • Herpes
  • HPV (warts)
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5
Q

How can you test for UTI in men

A
  • Urine analysis
    • Gonorrhoea and chlamydia from nucleic acid amplification testing (NAAT) - PCR
  • Urethral sampling
    • Gonorrhoea cultures
    • Gram stain microscopy
  • Rectal and pharyngeal samples
    • Gonorrhoea and chlamydia NAAT
  • Swab of ulcer base
    • Herpes simplex virus, syphilis
  • Bloods
    • Syphilis and blood born viral infections
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6
Q

How can you test for UTI in women

A
  • Triple swab test:
  • High vaginal swab
    • Bacterial vaginosis, trichomonas vaginalis, candida, group B strep
  • 2 endocervical swabs
    • Gonorrhoeae and chlamydia
  • Vulvovaginal swabs
    • Gonorrhoea, chlamydia NAAT
  • Urine
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7
Q

State the organism that causes chlamydia

A

Chlamydia trachomatis

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8
Q

Describe the presentation of chlamydia

A
  • Presentation in males - asymptomatic, urethritis, dysuria, prostatitis
  • Presentation in females - asymptomatic, urethra discharge, vaginal discharge
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9
Q

Describe diagnosis and treatment of chlamydia

A
  • Diagnosis
    • Vulvovaginal and endocervical swabs for NAAT
    • First catch urine NAAT - for men and women
    • Urethral swabs
  • Treatment
    - Doxycycline and azithromycin
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10
Q

State the organism that causes gonorrhoea

A
  • Neisseria gonorrhoeae

- Gram negative diplococcus

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11
Q

Describe the presentation of gonorrhoea

A
  • Men - urethral discharge, dysuria

- Women - asymptomatic, vaginal discharge, lower abdominal pain

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12
Q

Describe the diagnosis and treatment for gonorrhoea

A
  • Diagnosis
    • Gram stain from endocervical, vulvovaginal and urethral swabs
  • Treatment
    • IM ceftriaxone + oral azithromycin
      • Taken together as it boosts effect of ceftriaxone, decreases resistance to ceftriaxone and treat other possible infections such as chlamydia
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13
Q

State the organism that causes genital herpes

A
  • Herpes simplex virus (HSV) 1 & 2
    • HSV1 - usual cause of oro-labial herpes
      • HSV2 - more likely to cause recurrent symptoms
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14
Q

Describe the presentation of herpes

A

Asymptomatic, vaginal discharge, painful ulceration

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15
Q

Describe the diagnosis and treatment for herpes

A
  • Diagnosis - swab of ulcer base
    • Type specific serology - look for HSV antibodies which occurs if previous infection has happened
  • Treatment - Acyclovir (anti-viral)
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16
Q

State the organism that causes genital warts

A

Human papillomavirus (HPV)

17
Q

Describe the treatment of genital warts

A

Normally no treatment needed, topical application

18
Q

Describe the presentation of syphilis

A
  • Rash and painless ulcers first few weeks which disappears as bacteria enters latent stage
    • Up to 40 years later, may infect again
      • Not infectious in men, women can easily transmit to fetus (congenital syphilis)
19
Q

Describe the diagnosis and treatment of syphilis

A
  • Diagnosis - blood tests - Treatment
    • Early stage - penicillin
      • Late stage - antibiotics such as azithromycin
20
Q

Describe the presentation of trichomonas vaginalis

A
  • Men - urethral discharge, dysuria

- Women - vaginal discharge - green/yellow, frothy

21
Q

Describe the diagnosis and treatment of trichomonas vaginalis

A
  • Diagnosis - high vaginal swab

- Treatment - metronidazole

22
Q

State genital infections that are not STI

A
  • Scabies/pubic lice
  • Bacterial vaginosis
  • Vulvovaginal candidiasis
23
Q

Describe the presentation and treatment of scabies

A
  • Symptoms - itching and rash

- Treatment - permethrin

24
Q

Describe the cause and presentation of bacterial vaginosis

A
  • Commonest cause of abnormal discharge in women of childbearing age
  • Abnormal vaginal pH stimulates growth of bacterial vaginosis
  • Causes - douching, partner change, smoking
  • Fishy discharge, no itchiness
25
Q

Describe the diagnosis and treatment of bacterial vaginosis

A
  • Diagnosis - high vaginal swab

- Treatment - metronidazole

26
Q

Describe the cause and presentation of vulvovaginal candidiasis

A
  • Organism - mostly Candida albicans
    • Grow when vaginal environment such as pH altered where lactobacilli become replaced
      • Antibiotics, oestrogen oral contraceptives (oestrogen increases vaginal pH)
  • Present with vaginal discharge - thick, white
27
Q

Describe the diagnosis and treatment of vulvovaginal candidiasis

A
  • Diagnosis - high vaginal smear

- Treatment - topical and oral azoles, antifungals

28
Q

Describe the pathophysiology of pelvic inflammatory disease

A
  • Ascending infection from the endocervix and vagina
  • Infection causes inflammation, which damages Fallopian tube epithelium and cause adhesions to form
  • Endometritis - inflammation of the endometrium
  • Salpingitis - inflammation of the Fallopian tubes
    • Forms exudate that fills tube with pus
    • Can cause abscess and fibrosis within the tubule
  • Tubo-ovarian abscess - abscess forming in the tubule and ovaries
    - Potentially life-threatening if ruptured - sepsis
29
Q

State the causes of PID

A
  • Neisseria gonorrhoea
  • Chlamydia trachomatis
  • Bacterial vaginosum
  • Copper coil
30
Q

Describe the presentation of PID

A
  • Pyrexia, lower abdominal pain, abnormal vaginal discharge/bleeding
  • Examination - pyrexia, lower abdominal tenderness normally bilateral
31
Q

Describe the complications of PID

A
  • Ectopic pregnancy
  • Infertility
  • Chronic pelvic pain
  • Fitz-Hugh-Curtis syndrome - right upper quadrant pain following chlamydia

3 - Reproduction (17 decks)

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